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用于研究吸烟对菌斑与牙龈出血之间关联影响的重复测量多元多层次模型。

Multivariate multilevel models for repeated measures in the study of smoking effects on the association between plaque and gingival bleeding.

作者信息

Müller H P, Stadermann S

机构信息

Faculty of Dentistry, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait.

出版信息

Clin Oral Investig. 2006 Dec;10(4):311-6. doi: 10.1007/s00784-006-0067-y. Epub 2006 Aug 5.

Abstract

Multivariate multilevel modeling was applied to analyze repeated measures data on the influence of heavy smoking on the association between the amount of supragingival plaque and gingival bleeding on probing (BOP) in a steady-state plaque environment. Data acquired in 65 systemically healthy young adults with mild plaque-induced gingivitis were analyzed. 33 heavy smokers consumed at least 20 cigarettes per day while 32 were non-smokers. Periodontal examinations at the outset consisted of periodontal probing depth, clinical attachment level, BOP, plaque index, and presence of calculus at 6 sites of every tooth present. They were repeated 3 times every 8 weeks. A multivariate 4-level variance component model revealed that the odds of BOP was twice as high in smokers. In addition, females had a lower likelihood for BOP but, with increasing bleeding scores during the course of the study, this effect attenuated. Low biserial correlations for BOP at the site level of between 0.11 and 0.2 were found. At the tooth level, correlations were moderate (0.2-0.5), and highest at the subject level (0.8-0.9). Variations at subject and tooth levels were very large at the outset but notably attenuated in the course of the study. Plaque consistently influenced the tendency for BOP with an odds ratio of about 1.7-1.8 for each increase in score in both smokers and non-smokers. The present study did not reveal evidence for attenuation of the plaque/gingival bleeding relationship in heavy smokers.

摘要

采用多变量多层次模型分析在稳定菌斑环境下,重度吸烟对龈上菌斑量与探诊龈沟出血(BOP)之间关联的重复测量数据。对65名患有轻度菌斑性牙龈炎的全身健康年轻成年人获取的数据进行了分析。33名重度吸烟者每天至少吸20支烟,32名是非吸烟者。初始牙周检查包括每颗现存牙齿6个部位的牙周探诊深度、临床附着水平、BOP、菌斑指数和牙石存在情况。每8周重复检查3次。多变量四级方差成分模型显示,吸烟者发生BOP的几率是不吸烟者的两倍。此外,女性发生BOP的可能性较低,但在研究过程中,随着出血分数增加,这种影响减弱。在部位水平上,BOP的双列相关系数较低,在0.11至0.2之间。在牙齿水平上,相关性为中等(0.2 - 0.5),在个体水平上最高(0.8 - 0.9)。在研究开始时,个体和牙齿水平的变异非常大,但在研究过程中显著减弱。在吸烟者和非吸烟者中,菌斑均持续影响BOP的倾向,每增加一个分数,比值比约为1.7 - 1.8。本研究未发现重度吸烟者中菌斑/龈沟出血关系减弱的证据。

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